Valvular Heart Disease- Therapy Flashcards
(29 cards)
What is the difference between Type A and B aortic dissection?
Type A- involves the ascending aorta
Type B- does not involve the ascending aorta
What is meant by arteritides?
Inflammation of the arteries
What are some of the causes of ischaemic heart disease?
-Atherosclerosis
-Embolism
-Coronary thrombosis
-Aortic dissection
-Arteritides
-Congenital
What are some of the manifestations of coronary heart disease?
Angina
MI
Arrythmias
Chronic heart failure
Sudden death
What are the two groups of indications for CABG?
Symptomatic
Prognostic
What considerations need to be made when assessing whether a patient is suitable for a CABG?
-Adequate lung function
-Adequate mental function
-Adequate hepatic function
-Ascending aorta OK
-Distal coronary targets OK
-LV EF > 20%
Sometimes a saphenous vein from the leg is used in combination with a mammary artery for a CABG.
What is important to remember about the saphenous vein?
It contains valves so needs to be connected the right way or there would be no blood flow
Which two vessels are commonly used in combination for a CABG?
Mammary artery
Saphenous veins
Occasionally, which artery can be used in CABG?
Radial artery
What are some issues which may arise in sternotomy surgery?
Wire infection
Painful wires
Sternal dehiscence
Sternal malunion
Name three post-op risks of cardiac surgery.
Cardiac Tamponade
Death
Stroke
What are some of the primary features suggesting cardiac tamponade?
Raised CVP
Raised HR
Low BP
What are some of the secondary features suggesting cardiac tamponade?
Oliguria (reduced urine output), increased oxygen requirements, metabolic acidosis
What is the treatment for cardiac tamponade following cardiac surgery?
Reopening the chest
What are the two valves which more commonly require surgery?
Aortic and mitral valves
In Aberdeen, what are the three most common valve problems requiring surgery?
Senile Tricuspid AS
Bicuspid AS
Degenerative MR
What is rheumatic fever linked to?
Streptococcal infections
How is rheumatoid fever treated?
Aspirin and bed rest
What can rheumatic fever be an indication of?
Heart valve disease
Worldwide, what is the most common heart problem?
Chronic Rheumatic Heart Disease
How can you differentiate aortic stenosis and aortic sclerosis?
Aortic stenosis= loss of aortic S2
In those with mitral stenosis, when is surgery recommended?
When mitral valve area on ECHO is < 1.5cm2
In which condition is the murmur more easily heard- mitral stenosis or mitral regurgitation?
Mitral regurgitation
What happens is a cardiopulmonary bypass?
Blood drained from the RA and returned to the ascending aorta
